How Shame Gets In The Way of Postpartum Depression Recovery

It seems that the majority of my posts end up coming across as discussions on why it is important to reach out for support if you are struggling with a perinatal mood or anxiety disorder like postpartum depression, which makes sense, I guess, since I am a psychotherapist who specializes in supporting women through these issues.

Truthfully, what drives my topics every few weeks are the trends that I see here in my work, in an attempt to give a snapshot of what is REALLY happening for REAL women who are struggling through these often debilitating challenges. And so, today, I target both of these issues as I once again send out a plea for authentic and brave attempts for support and also a very true message about the reality that the shame associated with postpartum depression plays in the hindrance of this support.

Shame. It’s a strong word, right?

Mental illness is associated with all kinds of stereotypes: homelessness, joblessness, filth, insanity, murder, suicide, “craziness”, inadequacy, incapability … so many words and images that are frightening and downright unacceptable to many, many people. These stereotypes are also inaccurate, although many people who don’t have all of the correct information may not think so. Because of the misinformation out there about mental illnesses like postpartum depression and anxiety, people feel great shame when symptoms of mental illness become part of their reality. It’s no longer something to discuss about “other” people but actually something that is happening to themselves. And when mental illness happens after a new baby is born, at a time when the world leads us to believe that we are supposed to feel our best, shame can be at an all time high.

“How can a good, loving, acceptable mother also be mentally ill?” So many ask. It just doesn’t fit the picture that we hold of new mothers when we also associate this term with the above stereotypes, does it?

Mental Illness is a term that can feel harsh and critical and unfamiliar to many moms who suffer. And yet, the definition of “mental illness” isn’t as scary as we might assume. When I went online to see what definitions I could come up with, this is what I found:

Mental illness:

1. Any of various psychiatric conditions, usually characterized by impairment of an individual’s normal cognitive, emotional, or behavioral functioning, and caused by physiological or psychosocial factors

2. Any of various disorders in which a person’s thoughts, emotions, or behavior are so abnormal as to cause suffering to himself, herself, or other people

3. Any of various psychiatric disorders or diseases, usually characterized by impairment of thought, mood, or behavior.

“Impairment of thought, mood, or behavior” that is “abnormal” to that particular person. This is what it means to be mentally ill. To be depressed or anxious. To have postpartum depression, postpartum OCD or postpartum PTSD. And truthfully, although not every new mom will suffer with depression or anxiety after having a baby, it is pretty fair to say that nearly every mom will experience some impairment of thought, mood, or behavior when they suddenly enter motherhood. With depletions in sleep, nutrition, and support this is almost inevitable to some degree.

But back to the impact of shame. This is what I have seen in my work with moms:

The mom who waits for 10 months to call for support and is, at this point, stuck in a myriad of symptoms that are debilitating.

The mom who is pulling out her hair (a condition known as Trichotillomania) but who, despite a close relationship with her husband, will not let him know how deeply she struggles.

The mom who has tried everything to feel better — healthy nutrition, help at night so that she can sleep, childcare help so that she can take breaks and get exercise, reduced and more realistic expectations of herself as a mom — yet still suffers from extreme anxiety and depression but who will not try the medicine that is prescribed by her reproductive psychiatrist.

The mom who desperately needs community and love and support but who hides from those who she cares about because she cannot bear the thought of them knowing that she is not okay.

I am telling you, shame gets in the way of recovery and wellness.

And truthfully, this is a job for each of us. Every woman who has struggled with postpartum depression and who speaks openly about this begins that important job of reducing stigma. Every partner who non-judgmentally supports a mother breaks this down just a little more. Every blog post, every authentic media effort, every mental health awareness day helps the public learn more. Every time a man or woman steps up and tells a story in an effort to inform, validate, and support, one more mother might gain the courage to step on Shame’s head.

Related

Kate Kripke is a Licensed Clinical Social Worker (LCSW) specializing in the prevention and treatment of perinatal mood and anxiety disorders. She is also a Colorado state coordinator for Postpartum Support International. Kate lives in Boulder with her husband and two daughters and writes an eponymous blog.

Comments

Blogging about my mental illnesses (that word just looks wrong pluralized) has been a HUGE factor in minimizing the shame I feel. I still struggle to discuss it with my close friends and especially my parents. I think there’s a generational gap and they’re just so used to “not airing dirty laundry.” They’re even uncomfortable with me blogging, but I wish they understood how much freedom it’s given me. Freedom to separate myself from my medical condition and to treat myself like any other patient would treat themselves. So I’ll keep hacking away at the shame.

I am living in Denver CO and struggling severly with PPD. I just started seeing my therapist again, and am taking 100 mg of Zoloft since 10/18/12. I tried looking for other resourses in Denver for PPD support and coulnd’t find any. I see you are in Boulder, are there any you can provide to me?

You are so right. I struggle with being open with my family and close friends because of shame. Which is ridiculous. They love me regardless. But I know that the willingness to share, on behalf of others, inspired me to stand up and fight my own battle. I truly hope I can do the same for others.

It is interesting, because if a woman got diabetes and needed extra care and attention following her birth, she would probably be compassionate towards herself and talk openly about it. She could then get the support and educations she needs. We as a culture will have to reframe illness as neither mental or physical, but as simply illness before the cloak of shame disappears from individuals. Until then, it might be helpful for women to at least speak and think of themselves as unwell, and out of balance. Maybe just drop “mental illness” from the lexicon. Their hormones are wonky and it results in feelings and thoughts of hopelessness and despair. Let’s focus on the healing and loving them up. Healing from postpartum depression takes enormous strength and courage. Talking about the shame is a great way to disempower it. Thanks for the article, Kate.

While I so much agree on many levels, Alison, it gets us in a bit of a jam, doesn’t it? If we, and all of the mothers out three, are encouraged to speak openly but refrain from using the term “mental illness” then we are only playing into the stereotype and more people are misinformed. While struggles like PPD are most certainly struggles in which women are “unwell” and “unbalanced” we also know PPD to be a mental illness, like any other illness of depression or anxiety (or bipolar, or OCD etc). I have muddled through this in my own practice, when it comes to insurance codes and diagnoses…. on the one hand, I want to protect my moms from any stigma of mental illness (ie an “adjustment disorder” vs “major depression” with postpartum onset and yet, if I continue to do that insurance companies have no idea how many women are actually struggling. What to do, I am not sure. I would completely agree that if, in order to reach out, a mom needs to talk about her struggles without using the term “mental illness” than she should absolutely find the words that feel most fitting to her (unwell, out of balance etc)… but you bring up a question that I think about often… Thank you for your voice here!!

Shame sucks. I am that mom who waited 8 months until it was so bad that the hospital was the only option. I didn’t tell anyone. And now I tell everyone. I kicked that shame in the butt. Better late than never.

At first, it was really hard to start being open and blogging about my PPD; I didn’t really talk about it with much of anyone until I found out it was related to pregnancy-induced hypothyroidism that we didn’t know I had. I was SO scared that people would judge me and find me lacking, look down on me, etc. You could be describing how I felt in this post.I realized, though, that the more I talked and blogged, the more open I was about it, the more free I felt and the LESS shame and fear I felt. Now I talk about PPD and my story any chance I get and can be hard to get to stop talking about it. 😀 It feels like when I choose to talk and blog and tweet and FB about PPD, I take the power and control back into my own hands. Instead of it controlling me and who I tell/when, I control that. And after the terrifying LACK of control I felt when I was going through it all, I’ll take any ounce of power I can get over that jerk.

A great post Kate, a wonderful call to action. I agree – its shame that paralyses so many of us. Brene Brown does great work on shame and its buddies. Her research and subsequent books and TED talks have been speaking to us all about how to recognize our own shame and the prevalence of shame in society (in general) – specifically in her early work related to women. She is a Mom too so that means lots of examples that we can all relate to.

I work with Moms with PPD and women in general. The sharing, the empathy from others, the blog posts and writing that is going into getting the word out that there is nothing to be ashamed of all helps a great deal. Your call to action makes me smile with hope and positivity. thank you for all you do. As Brown says “the antedote for shame is two words: “me too” sarah xx

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[…] shame getting in your way of reaching out or receiving the support and treatment you need? If so, come and gather the energy to knock that shame down over at Postpartum Progress. I’m … Share this:FacebookLinkedInTwitterEmailLike this:LikeBe the first to like […]

[…] when a woman experiences counterintuitive thoughts and feelings toward her child and motherhood, the shame and guilt she feels prevents her from seeking treatment. Such a woman may try to downplay these thoughts, to […]

[…] when a woman experiences counterintuitive thoughts and feelings toward her child and motherhood, the shame and guilt she feels prevents her from seeking treatment. Such a woman may try to downplay these thoughts, to […]

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Postpartum Progress exists to provide peer-to-peer support. The information on this site is for educational, advocacy purposes only. It is not intended to diagnose or treat any medical or psychological condition. Please consult your own health care provider for individual advice regarding your specific situation and needs.